Change of hemostasis in the ATRA therapy of acute promyelocytic leukemia

Aim. To study hemostasis in ATRA treatment of acute promyelocytic leukemia (APL). Material and methods, Hemostasis,vas studied in 8 newly admitted APL patien ts treated with A TRA. All of them had hemorrhages, thrombocytopenia 5-15 . 10(9)/l at diagnosis, laboratory signs of the DIC syndrome at induction the rapy. Results. Hemorrhage arresting was seen on the ATRA therapy day 14 to 30. Du ration of thrombocytopenia under 20 -10(9)/l was 5.8+/-1.8 days. After 7 da ys of ATRA therapy coagulation tests improved with some hypercoagulation te ndency. Subsequent condition of hemostasis was considered as normo/hypercoa gulation accompanied by constant thrombin persistence (in the presence of F DP) and depression of hageman-dependent fibrinolysis even in remission. A c ase of ileofemoral thrombosis followed by fatal thromboembolism of the pulm onary artery is reported. Conclusion, If is suggested to rise heparin, especially low molecular weigh t heparin when there are signs of hypercoagulation in APL patients.